title: Experienced psychiatric nurses' clinical judgments in everyday practices.
abstract: The purpose of this study was to explore the characteristics of clinical judgment through uncovering the everyday practices of experienced psychiatric nurses. Participants were 13 nurses and 4 licensed assistant nurses who worked at a private mental hospital. The participants were interviewed and encouraged to describe their everyday practices and clinical judgment episode. The narrative texts were interpreted by the researcher in this study. As a result, the following characteristics emerged: 1) Clinical judgment embedded in everyday practices is based on the experienced nurse's expert ability of knowing the patient and grasping the patient's situation; 2) Clinical judgment is clinical wisdom, including intuition, based on the nurse's experience; 3) Clinical judgment in patient-nurse interactions is strongly affected by closeness/distance in the relationship. Clinical judgment is not context free, rather it is very situational; 4) When group consensus and the nursing care plan exert conformity pressure, the group consensus tends to obstruct the development of an individual nurse's judgment.
authors.affiliation: St. Luke's College of Nursing, Tokyo.
authors.forename: Y
authors.initials: Y
authors.lastname: Nakayama
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007600:Judgment; D009730:Nursing Assessment / Q000592:standards*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education* / Q000523:psychology*; D011568:Psychiatric Nursing / Q000592:standards*; D011795:Surveys and Questionnaires